Journal of the International Neuropsychological Society



Comparison of the serial position effect in very mild Alzheimer's disease, mild Alzheimer's disease, and amnesia associated with electroconvulsive therapy


PETER J.  BAYLEY a1a3c1, DAVID P.  SALMON a1a3, MARK W.  BONDI a2a4, BARBARA K.  BUI a1, JOHN  OLICHNEY a1a3a5, DEAN C.  DELIS a2a4, RONALD G.  THOMAS a1a3 and LEON J.  THAL a1a3a5
a1 Department of Neurosciences, University of California, San Diego
a2 Department of Psychiatry, University of California, San Diego
a3 Alzheimer's Disease Research Center, University of California, San Diego
a4 Psychology Services, VA San Diego Healthcare System
a5 Neurology Services, VA San Diego Healthcare System

Abstract

Individuals given a series of words to memorize normally show better immediate recall for items from the beginning and end of the list than for midlist items. This phenomenon, known as the serial position effect, is thought to reflect the concurrent contributions of secondary and primary memory, respectively, to recall performance. The present study compared the serial position effects produced on Trial 1 of the California Verbal Learning Test (CVLT) in mildly demented (N = 25; M MMSE = 20.0) and very mildly demented (N = 25; M MMSE = 25.5) patients with Alzheimer's disease (AD), and age- and education-matched normal control (NC) participants (N = 50). In addition, the serial position effects of the very mildly demented AD patients were compared to those of patients with a transient, circumscribed amnesia arising from a prescribed series of electroconvulsive therapy (ECT) treatments for the relief of depressive illness (N = 11). While the NC group exhibited the typical serial position effect, AD patients recalled significantly fewer words than NC participants overall, and exhibited a significantly reduced primacy effect (i.e., recall of the first 2 list items) with a normal recency effect (i.e., recall of the last 2 list items). Patients with circumscribed amnesia due to ECT were as impaired as the very mildly demented AD patients on most standard CVLT measures of learning and memory, but exhibited primacy and recency effects, which were within normal limits. These results suggest that a reduction in the primacy effect, but not the recency effect, is an early and ubiquitous feature of the memory impairment of AD. It is not, however, a necessary feature of all causes of memory impairment. (JINS, 2000, 6, 290–298.)

(Received January 28 1999)
(Revised May 27 1999)
(Accepted June 15 1999)


Key Words: Alzheimer's disease; CVLT; ECT; Serial position effects.

Correspondence:
c1 Reprint requests to: Peter J. Bayley, Alzheimer's Disease Research Center, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0948.